Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Covid 2/9/22: Interferon λ, published by Zvi on February 9, 2023 on LessWrong.

There are two big pieces of pandemic news this week.

One is that there is growing alarm about the dangers of avian flu, or H5N1. Likely mammal-to-mammal transmission has been identified, a lot of wild animals are infected, and there is a real danger that this will become a pandemic. I will cover this in its own post.

The other is that there are trial results for a new Covid treatment, Interferon λ. It looks super effective. Cuts hospitalizations and deaths in half, with no major side effects.

Despite this, there is zero expectation by anyone that it will be available any time soon, and little surprise about this reaction. You see, the trial was done by academics and was in Brazil and Canada. So it doesn’t count. Sorry.

Executive Summary

We have a new drug that cuts Covid risk of hospitalizations and deaths by about half with no major side effects.

You can’t have it. Maybe ever.

Because FDA. FDA Delenda Est.

Let’s run the numbers.

The Numbers

Predictions

Predictions from Last Week: 210k cases (-8%) and 3,150 deaths (-8%)

Results: 238k cases (-6%) and 3,052 deaths (-11%)

Predictions for Next Week: 220k cases (-7%) and 2,750 deaths (-10%).

Last week I forgot to manually adjust Florida for cases, which I’ve fixed. That’s why the percentages above don’t match. Also means my prediction last week for cases was worse than I thought – cases were actually slightly up and I predicted a drop.

I expect deaths to continue to drop on schedule. Valentine’s Day is not a reporting-relevant holiday, although it is still a date it is important not to forget.

Deaths

Cases

Interferon λ

As noted up top: It looks super effective. Cuts hospitalizations and deaths in half, with no major side effects. Despite this, there is zero expectation by anyone that it will be available any time soon, and little surprise about this reaction.

Here is their results summary.

A total of 933 patients were assigned to receive pegylated interferon lambda (2 were subsequently excluded owing to protocol deviations) and 1018 were assigned to receive placebo. Overall, 83% of the patients had been vaccinated, and during the trial, multiple SARS-CoV-2 variants had emerged. A total of 25 of 931 patients (2.7%) in the interferon group had a primary-outcome event, as compared with 57 of 1018 (5.6%) in the placebo group, a difference of 51% (relative risk, 0.49; 95% Bayesian credible interval, 0.30 to 0.76; posterior probability of superiority to placebo, >99.9%). Results were generally consistent in analyses of secondary outcomes, including time to hospitalization for Covid-19 (hazard ratio, 0.57; 95% Bayesian credible interval, 0.33 to 0.95) and Covid-19–related hospitalization or death (hazard ratio, 0.59; 95% Bayesian credible interval, 0.35 to 0.97). The effects were consistent across dominant variants and independent of vaccination status.

Among patients with a high viral load at baseline, those who received pegylated interferon lambda had lower viral loads by day 7 than those who received placebo. The incidence of adverse events was similar in the two groups.

I am completely unsurprised both by our government denying people access to life saving medicine as a matter of course. And also completely unsurprised by the complete indifference of the public to our government indefinitely denying everyone access to life-saving medicine.

Paxlovid was the last gasp of the old ‘people are dying and we upended our lives to try and stop this, perhaps we should unnecessarily delay less than usual in deploying life saving medicine’ principle.

This is standard procedure. The FDA exists to deny people life saving medicine. For years. Instead, during that time, they die. No rush. If there isn’t enough money to justify paying to get through the process, t...